- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $43.65 / $72.44
| Professional | | $32.36 | $43.65 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $33.88 / $56.23
| Professional | | $28.84 | $33.88 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $45.71 / $60.26
| Professional | | $36.31 | $45.71 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $53.70 / $223.87
| Professional | | $34.67 | $53.70 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $32.36 / $33.11
| Professional | | $14.45 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $43.65 / $67.61
| Professional | | $30.20 | $43.65 | $67.61 |